Documente Academic
Documente Profesional
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Asiguratul / păgubitul__________________________________
Tamas Ionita CNP 1 9 2 1 1 0 7 1 2 4 9 3 8
CNP/CUI
CNP/CUI
CNP/CUI
CJ92JHN
proprietar al autovehiculului cu nr. de înmatriculare ________________________________ reprezentat
prin___________________________________________ conform imputernicirii depuse la dosar, va rog
1409
sa aprobati plata despagubirii in suma de: ____________
Obiectii:____________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
Asigurat/Pagubit
06.03.2023
Data ___________ Semnătura/ştampila __________________